PARTOGRAF

No.RegisterNamaIbu/Bapak: ------------------/--------------- Umur :------/----- G....P....A....Hamil..........mingg

RS/Puskesmas/RBMasukTanggal: Pukul:-------------WIB

KetubanPecahsejakpukul---------- WIB Mulessejakpukul------------------WIB ALAMAT :.........................................

Denyu
150
Jantung
140
Janin
130
( x/menit) 120
110
100
90
80

airketuban
penyusupan

10
9
Pembukaanserviks(cm)

8
7
beritandaX

6
5
Turunnyakepala

4
BeritandaO

3
2
1
0
Waktu
(Pukul)
Kontraksi < 20 5
tiap 4
20-40
3
10 menit > 40 2
(detik) 1

OksitosinU/I
tetes/menit

Obatdanc
airanIV
Nadi 180
170
160
150
140
130
120
Tekanan 110
darah 100
90
80
70
60
o
Temperatur C
Protein
Urine Aseton
Volume

Makanterakhir:Pukul....................Jenis:..............................Porsi:............................
Minumterakhir:Pukul....................Jenis:..............................Porsi:............................

…………………………….. , …………………… 20
BidanPenolong,

Lili Elisa S.ST.Bdn

( Tandatangan, NamaJelasdan Cap )
Lembar partograf bagian belakang
CATATANPERSALINAN

Tanggal:...............................................PenolongPersalinan:li,S.ST
Tempatpersalinan:[]rumahibu[]Puskesmas[ ]KlinikSwasta[ ]Lainnya...................................................................................
Alamattempatpersalinan......................................................................................................................................................................

KALAI
[ ]Partografmelewatigariswaspada
[ ] Lain-
lain,Sebutkan...........................................................................................................................................................................Penatalak
sanaanyangdilaksanakanuntukmasalahtersebut:............................................................................................................
Bagaimanahasilnya?:..........................................................................................................................................................................

KALAII
LamaKalaII:............................................menitEpisiotomi:[ ]tidak[ ]ya.Indikasi:...................................................
Pendampingpadasaatpersalinan:[]suami[]keluarga[ ]teman[]dukun[ ]tidakada
GawatJanin:[ ]miringkanIbukesisikiri[ ]mintaIbumenariknapas[]episiotomi
DistosiaBahu:[ ]ManuverMcRobertIbumerangkang[ ]Lainnya.......................................................................................
Penatalaksanaanuntukmasalahtersebut:.....................................................................................................................................
Bagaimanahasilnya?:....................................................................................................................................................................

KALAIII
LamaKalaIII:............................................menit JumlahPerdarahan:.............................................ml
a. PemberianOksitosin10U IM<2menit? [ ]ya[ ]tidak,alasan........................................................................................
PemberianOksitosisulang(2x) ?[ ]ya[ ]tidak,alasan................................................................................ b.
Pemegangantalipusatterkendali?[ ]ya[ ]tidak,alasan........................................................................................ c. Masasefundusuteri?
[ ]ya[ ]tidak,alasan........................................................................................Laserasiperineumderajat..................Tindakan:
[ ]mengeluarkansecaramanual [ ]merujuk
[ ]tindakanlain.................................................................................................Ato
niauteri:[]Kompresibimanualinterna[ ]MetilErgometrin 0,2mg IM [ ]Oksitosindrip
Lain-lain,sebutkan:...............................................................................................................................................................................
Penatalaksanaanyangdilakukanuntukmasalahtersebut:..................................................................................................................
Bagaimanahasilnya?:.........................................................................................................................................................................

BAYIBARU LAHIR
BeratBadan:.................gramPanjang:.................cm JenisKelamin:L/PNilaiAPGAR :......../......../........
PemberianASI<1jam []ya[]tidak,alasan..................................................................................................................................
Bayibarulahirpucat/biru/lemas:[ ]mengeringkan[ ]menghangatkan[]bebaskanjalannapas
[ ]stimulasirangsangaktif[]Lain-lain,sebutkan:.................................................................
[ ]Cacatbawaan,sebutkan:................................................................................................................................................................ [ ]
Lain-lain,sebutkan:..........................................................................................................................................................................
Penatalaksanaanyangdilaksanakanuntukmasalahtersebut:............................................................................................................
Bagaimanahasilnya?:.........................................................................................................................................................................

PEMANTAUAN PERSALINAN KALAIV

Tinggi
Jam Tekanan Kontraksi Kandung
Pukul Nadi Suhu Fundus Perdarahan
ke Darah Uterus Kemih
Uteri

MasalahKalaIV :...................................................................................................................................................................................
Penatalaksanaanyangdilaksanakanuntukmasalahtersebut:............................................................................................................
Bagaimanahasilnya?:..........................................................................................................................................................................

KIE
No Tanggal Materi Pelaksana Keterangan
Semuanifas
Breastcare
ASI
PerawatanTaliPusat
KL
Gizi
Imunisasi